Transitions

I was at a Christmas party this weekend when someone casually asked me, where I live. Normally this is pretty basic Q&A party convo.  But I stood there, deer in the headlights, struggling with the answer until I awkwardly blurted out, "Well...I'm kind of homeless". Yep, that's me, 35 years old, masters degree, loads of student debt and well...homeless.

Turns out, following your heart requires a lot of sacrifice and a whole lot of uncertainty. I've been quiet on the blog scene for a few months. When things are tough, it's easier to hide than to live your vulnerabilities in print. This being said, it's when we are most vulnerable that we connect the most with those around us. 

My decision to leave Honduras was not easy by any means. It came abruptly yet it was necessary.  I was serving our precious little Honduran patients, mothers fanning babies suffering for hours in squelching heat to see me. I loved every minute of those visits, loved those adorable little hands and those runny little noses, but I hated that I had so little to offer in return. Our clinic didn't have basic vitamins or paper towels to dry your hands after washing. I would lance abscesses without as much as antibiotic ointment to put on the wound. It was appalling, really. 

I was constantly petitioning the non-profit I represented for funds to supply these necessities, and yet the answer was often "we need to focus more on sustainable projects", translation, no! The ugly truth is despite our lack of funds, I was asked by our academic partner for signatures on research projects. Projects born in SF to be carried out in a hospital that didn't even have running water. Ideas from academics who wanted grants or research without any question as to if it was even needed or wanted by those it most affected. Morally, I just couldn't be a part of it. 

I believe global health should be a bottom up approach. Research, projects, ideas and initiatives should originate from those who are most affected. The incentive should be born by the people you hope to serve. Then, you take those needs, those desires for change, and make them a reality by plugging in your resources in a SYMBIOTIC exchange. The idea that WE have all the answers, and WE know what needs to happen is not only offensive, it's just inaccurate. 

In light of this revelation and let's be honest with an empty bank account, I moved back to California.

Finding myself yet again with a blank slate and a questionable future, I tried to remain calm in the face of uncertainty. I was crashing in my brother's old bedroom (my poor parents have yet to experience an empty nest), and working temp jobs while trying to figure out WHAT in the world I would do next. 

Around this time my mom asked, "Why don't you just work for Operation Smile? That's always where you are the happiest?". I didn't know of any paid jobs with Op Smile. I'd been volunteering with them since 2008 but it was always just that, voluntary.  Well, fate has a funny way of showing up when you least expect it to. It's kind of like the guy you're crushing on who waits until 8 pm on a Friday to ask you on a Saturday date. Just when you've sworn him off, BOOM he calls. And so it goes, the morning after a pity party, I woke with swollen eyes and a bit of a wine headache to find an email from Op Smile waiting ever so patiently in my inbox. WANTED: Full-time nurse educator for position in Guwahati India. 

Ummm...YESSSS!  I told them they had to hire me because my mom thinks I'm perfect for the job (obviously the best way to approach a cover letter)! Turns out I had some stiff competition, my best friend also applied! She's basically an Op Smile rock star so I knew it'd be tough call. I can honestly say I believe in her so much that I felt that if either one of us got the job, it really was the right decision. She is hands down fantastic. 

I waited in agony until October. Here I am, about to board a flight to Dominican Republic for yet another Op Smile mission when I see an email stating that they want to interview me! Whoohoo! Well, guess what? I arrive to our first team dinner...mind you we are in Dominican Republic and guess who is sitting across the table? Alex and Carolina, basically the mom and pop of all things Op Smile India. Alex and Carolina started the Guwahati project from the ground up. They are responsible for taking it from an empty room to the leading cleft center in the world. And here they are...at my dinner table...IN DOMINICAN REPUBLIC.

And it get's better...just for background...I met them 7 years ago in Alexandria Egypt when they first met and consequently fell in love! Carolina was my roommate when they were surgical residents. I even had a photo of Alex on the phone with her at the pyramids on a camel! It suffices to say I felt like Santiago in Paulo Cohelo's Alchemist. Yes to India, yes to my destiny...YES to UNCERTAINTY...YES TO CHANGE. 

And so it happened...I'm moving to Guwahati India the beginning of January. My job will entail being a nurse educator for the local Indian Op Smile nurses. We are developing curriculum and training nurses to become advocates and leaders in the field. This job couldn't be more perfect for me. It's a mix of all things pura allegra; travel, adventure, clinical care, teaching, mentoring and encouraging nurses to reach their fullest potentials.

So that's how it happens, 35, years old, single, "high class homeless" and ready to embrace another year of highs and lows doing what I love.

My new temp job USA style! 

Carolina, Me and Alex in their private practice in Cartagena, Colombia

Last few days in Roatan, Honduras

Dominican Republic Mission...where I re-met Alex and Carolina after 7 years

Alex getting that fateful call from Carolina...the moment destiny intervened 

Camp for Grown Ups

I just got back from a week and a half in Chiapas, Mexico with Operation Smile. 

Operation Smile missions are equivalent to a strong cup of coffee on an early morning. They totally reinvigorate me, they fill me with pure joy and for the entire length of the mission my face is nothing but smiles. 

Between with my intensive graduate and post-graduate programs and my new role as a nurse practitioner I simply didn’t have the "luxury of time" to spend on these trips. I turned down opportunity after opportunity with Operation Smile to travel the world with incredible people while doing what I love. What I didn’t realize at the time was I didn’t have the "luxury" to say no either. Each time I turned down a mission it felt like a someone turned down the burner on my fire. 

This is why when I got a call 2 weeks before the Mexico Mission saying they needed a last minute recovery room nurse I jumped at the chance. Our work was based out of San Cristobal a charming little city in Mexico with a very European feel. It reminded me a lot of Antigua Guatemala with it’s cobblestone streets, flower boxes hanging from brightly painted houses, and live music on every corner. The streets are lined with pubs, wine bars, cafes and great little restaurants filed with bohemian Mexican hippies. The central park has a big white gazebo where you can order Mexican hot chocolate and listen to live calypso music. 

Small tienda in San Cristobal

Selling balloons in San Cristobal

San Cristobal

Yet beyond the beautiful esthetics of San Cristobal lie it’s most brilliant treasure, it’s indigenous people. Chiapas has 3 main indigenous ethnic groups each with their own distinct language and culture. It is one of the largest concentrations of indigenous populations in Mexico and with over 56 different languages spoken.

family waiting for screening wearing traditional clothes

Selling flowers on the streets of San Cristobal

Screening (the 2 day clinic where we screen kids for surgery) was filled with parents and children dressed in a manner distinct to their indigenous group. Many women wore colorful blouses with elaborate hand embroidered flowers and black wool rebozos which look like animal hair skirts. Their hair was neatly tied in two long braids with ribbon interwoven between the strands. 

Indigenous man entering a church

Indigenous woman

An indigenous woman selling handmade goods on the street

One such beautifully dressed indigenous girl was Xochil.  Xochil is a 12 year old girl born with a bilateral cleft lip which distorted her appearance so much so that her parents kept her home all day, everyday. In fact, the day I met her in clinic was the first time she’d ever left her house in her entire life.

Daniella, one of our outstanding volunteers came across her while searching for children in remote areas of Chiapas who needed help. With Daniella's encouragement, Xochil's family made the journey into San Cristobal and received a gift they never believed would be theirs; Xochil has a new smile. She can go to school for the first time in 12 years. She no longer has to hide inside her room imagining what life is like outside her door. She has a chance to live, to explore, to be a child! I couldn't help but beam as I handed Xochil back to her mom after her anesthesia wore off. Our entire team cried along with her family as they uttered a million thank you's and blessings. In reality, I was the one who felt totally and utterly blessed. 

Vania is another pumpkin who stole my heart during surgery week. Vania is a beautiful little 8 year old girl who had a cleft lip and a cleft palate repaired 2 years before which left her with a slightly deformed nose and a speech impediment. She was constantly bullied at school for her physical differences. In fact, when I met her she had a black eye from being beaten up at school the day before. Vania has the sweetest little smile and talks a mile a minute about disney princesses. Although her impediment made it difficult to understand much of what she was telling me, her spirit spoke volumes. 

When Vania's mom brought her to us she had convinced herself that we might not do Vania's surgery because in the past she'd been denied by previous doctors who told her it was unnecessary since it's "only cosmetic". She was so distraught that we might turn her down that she immediately began crying and pleading with us as soon as she walked in the room. We understood that although Vania's defect might appear cosmetic the wounds she suffered as a result of it were not merely superficial. Vania was selected for surgery that week, and now she has a beautiful little nose. 

Vania during screening week

Despite my  physical fatigue from working 14-16 hour days at the hospital, my soul never felt so alive. I found myself belly laughing at the silliest things and waking up with sore cheeks from smiling all day. We performed 106 surgeries on this mission, each one drastically changing the fate of children who might not otherwise have a shot at a normal life. I worked with an incredible team. I reunited with old friends I’d made all over the world on previous missions and made beautiful new ones who were immediate kindred spirits. As my friend Skylar said, “it’s like camp for grown-ups”.  A camp I can’t afford to miss out on!

Part of our international team, Guadalajara, El Salvador and California

A mom and her daughter just about to get vital signs done

A little pumpkin just waking up from anethesia

Kids waiting to be screened

Our Recovery Room Team

If you feel inspired to help me serve you can donate to my mission by clicking here. Every little bit helps! Thank you for your support! I could not do any of this without you!

Esperanza

My first day at Clinica Esperanza was fantastic. By the time I arrived at 7:30 am there was already a line of patients spilling out the door, over the deck on into the grass surrounding the clinic. I spent the day learning about common illnesses on the island and soaking up everything I could from Dr. Rapheal, a wonderful local pediatrician. We tested 3 children from malaria, thankfully none of which came back positive. I also learned that a plastic cup with a hole cut out the bottom makes a great spacer for asthma medications. 

Inside Clinica Esperanza

Clinica Esperanza

The Famous Miss Peggy with the poster in the airport that started this whole adventure for me!

I’ve also started working at the Public Hospital in Coxen Hole. There is a stark and tragic contrast between this and Esperanza. On my first day there I was horrified to open the door of what really appeared to be a shed outside the main building to find a woman with Dengue receiving a free flowing blood transfusion without any monitoring or medical personal in the room. The labor and delivery “unit” consisted of cots lined up side by side with nothing but buckets to use if they needed to use the bathroom. There was very little access to running water for hand washing. Many of the beds didn’t have linens and I was told many families just bring their own. Despite this Global Healing has started a wonderful pediatric clinic here and is working with UC Berkley and UCSF to bring greatly needed resources to the hospital.

Public Hospital

Labor and Delivery Ward

Operating Room

Global Healing Doctors waiting for patients to arrive

My week ended on a high note. We were invited to a joint meeting with all the local doctors and the Clinica Esperanza team in order to discuss emergency Medical Evacuation possibilities through the U.S. Military. They have decided to collaborate with us by helping to evacuate critically ill and unstable patients off the island to higher levels of care. This makes a life saving difference on the island for all the people living here who would otherwise not have such a chance. It’s such an incredible opportunity. And to put the cherry on top of it all they let me sit in the cockpit of the helicopter! 

Me with our Army Guys! 

Trying to look cool while not launch a missile accidentally

Reflecting on all the week I can’t get past the name of Clinica Esperanza. Esperanza is Spanish for hope. It couldn’t be a more fitting title and how ironic that it’s where I ended up. In the previous 6 months during the bleakest points of my depression, I found myself stripped of my ability to hope. The possibility of a brighter future felt so impossible I couldn’t even fathom it. Being such a naturally optimistic, positive person it was as if I’d completely loss the essence of myself. I distinctly remember the day I had my first glimmer of “esperanza”. It was simple and fleeting but for the few seconds it crossed my consciousness it felt like seeing a shooting star in the darkest night. 

Here I am six months later and I’ve launched myself into my greatest adventure yet, fully embracing a life I never imagined could be so colorful and working at “The Clinic of Hope”.

If you feel inspired to help me serve you can donate to my mission by clicking here. Every little bit helps! Thank you for your support! I could not do any of this without you!

Lions and Tigers and Pythons...Oh My!

Today marks the end of my first week in Roatan. I had little idea what to expect stepping onto the hot tarmac at Roatan’s little airport and to be honest one week later I still have no idea what to expect. 

Frenchies Key

I spent my first weekend here relaxing with some new Honduran friends. We went to a beautiful little key right off this island called Frenchies. It’s honestly one of the most beautiful beaches I’ve ever seen. After getting sufficiently sunburned we took the scooter all the way down to Punta Gorda, a Guarifuna community in the north western part of the island. 

Scooter ride

Frenchies Key

This island has such an interesting mix of cultures between the original islanders, the Guarifunas, and immigrants from mainland Honduras who moved here looking for a better way of life. The Guarifunas are descendants of Africa who migrated to Roatan after British invasion of St. Vincent in the Caribbean. They’ve managed to stay a coherent community with their culture and language left mainly intact. 

Entering Punta Gorda literally felt like stepping into a West African village somewhere. We were greeted by live drumming and Carribbean dancing. We ate dinner in under the shelter of palm fronds and grass while children as young as 2 years old were dancing around their older siblings as their parents played the drums. It was absolutely invigorating! I passed the afternoon trying to ‘shake it like Shakira’  and playing futbol barefoot in the dirt with a group of local boys. 

But it just got better...As our scooter hugged dark curves along the winding road home we came across what I thought was a large branch in the middle of the street. We whizzed by but then to my surprise we turned around and headed back to the dark shape strung across the road. As our headlights illuminated this large branch I realized, it wasn't a branch at all but a python just hanging out in the road. Snakes are not my favorite animals on the planet. So you can imagine I was less than calm as my friend jumped off the scooter, grabbed the python by his tail and drug him to the safety of some nearby brush! Welcome to the jungle! 

If you feel inspired to help me serve you can donate to my mission by clicking here. Every little bit helps! Thank you for your support! I could not do any of this without you!

Saying Goodbye

My last two weeks in San Francisco were crammed full of goodbye parties, lunches, brunches, celebratory cocktails and dinner parties. They were so full of laughter, toasts, encouragement and love. Every time I opened my email there was a letter from someone wishing me their best. I never realized how much love surrounded me! I joked with my sister that this was the closest you can come to sitting in on your own funeral while everyone talks about you! It was a high like I’ve never experienced, a warm feeling that soaked all the way to my bones. 

Family Goodbye Party

SFRRC Goodbye Party

I was so humbled and really just blown away by the incredible outpouring of support and encouragement. I couldn’t believe the generosity and love that seemed to be coming from every corner of my life. People I haven’t seen since high school, friends I met while traveling abroad, colleagues from jobs past, salsa partners I haven’t seen in over 6 years, friends of friends, people I’ve never even met all gave to a capacity that just amazed me. I felt so incredibly honored, so lucky to be surrounded by such beautiful souls. I never expected to feel so loved! 

Last Saturday Run with SFRRC

With all the business surrounding me, I don’t think the reality of what I was doing set in until Sunday night as I began packing. As I folded my clothes neatly into my $20 dollar craigslist suitcases, I was surprised by hot tears rolling down my cheeks.  The reality of leaving behind my friends, my family, Alex and the community I’d spent the last few years building, hit me hard. I didn’t feel regret but I did grieve. My grief needed the act of packing to surface. With each item I placed into my pack or decided to put into a box to store I realized the gravity of all I was leaving behind and the unknown that awaited me on the other side. In the end, after selling all my things and storing what little tokens I couldn’t part with I had 3 suitcases to show for my 34 years. I felt the loss of a life I never imagined I’d leave. 

My sister surprised me with a trip up from San Diego to help me pack

My final 24 hours were so hard. I fought back the voices telling me I was crazy, I battled the what-ifs that crept in and spun wild stories about all the potential dangers of leaving my nest, and the self doubt the that told me I wasn’t cut out for this.  As I changed into my traveling clothes I caught my tattoo in the mirror. Four arrows, one to represent each of my siblings. A symbol we all got to represent the  strength we have when we are together. An arrow is pulled back just enough, held in a temporary position of discomfort and tension long enough to find a target and then soar freely in it’s intended direction. The stretch and pull are necessary, you have to feel the pain, the discomfort of uncertainty to embrace the freedom that lies ahead. 

With this image in mind, I overcame my demons and I boarded my plane to Honduras! 

Saying final goodbyes at the airport

Roatan Aeropuerto

My Parents with their version of our ARROW tattoos! 

If you feel inspired to help me serve you can donate to my mission by clicking here. Every little bit helps! Thank you for your support! I could not do any of this without you!

The first day of the rest of my life...

And so that's what happened! I returned to my favorite city and started the Acute Care Pediatric Nurse Practitioner Program at UCSF. While in school, I entered a Global Health Pathway program where I was exposed to global medicine on a new level. I was humbled by the realization that despite our best intentions "missionary medicine" can often do more harm than good. I learned about the unintended devastating effects our interventions can cause within the very communities we hope to em-better. My studies in global health caused me to take a step back. Although I fully appreciated the impact my intensive care skills had in short term missions, I wanted to make more of a difference up stream. Many acute care problems can be prevented with good primary care. And so, with this in mind, I decided to get a post-masters in Primary Care. 

All this schooling left me well...wanting more! I've always felt a pull to work with Latino families. I love the warmth and vibrance my Latino patients bring to my practice. But I knew so many families received substandard care as the result of medical practitioners by overestimating both their  own language proficiency and their patients' comprehension. The only way I'd feel confident I was giving the best care possible was to become fluent in Spanish. So...I moved to Guatemala. I lived with a Guatemalan family in the chilly city of Quetzaltenango. There I took one-on-one Spanish lessons for 8 intense hours a day. Once I was able to communicate efficiently I really enjoyed life in Guatemala. I loved the people I met, the colors worn by the indigenous women and of course the tamales! 

I craved this experience back home. So in an attempt to bring Latin America to me, I moved to the Mission, SF's notably most Latino district and applied at San Francisco General Hospital. SFGH is an incredibly busy county hospital serving everyone in the city despite insurance. On the pediatrics side I'd estimate about 85% of my patients were from monolingual newly immigrated families without the socioeconomic resources necessary to go anywhere else. That being said, we provided the highest standard of care. Most of my colleagues worked both at the General and UCSF. They were some of the most accomplished, brilliant providers I've ever worked with. I felt so proud to be among a team of such compassionate, talented, driven colleagues.  Yet after two years I began to realize that my heart was pulling me somewhere else. 

I began to lose joy in little things. Though I still loved seeing all my patients' names show up on my morning schedule, I began to dread the long hours spent after clinic doing all the tasks I could never seem to catch up on. Little by little my spirit weakened. I kept pushing myself, more focused on the tasks than the heart of what I lie before me. Until one day it came to a screeching halt. All the stress and worry caught up with me and I landed myself into a major depressive episode forcing me to take a leave of absence. I spent 6 months climbing out of that hole. Thanks to my amazing friends and family I made it through to the other side. As I was recovering, I decided to go on a trip to Nicaragua and Honduras. My family thought it would be good for me to get back to doing things I loved before returning to work. 

Little did they know how good it would be. In Nicaragua I lived with a local family yet again. Only this time I could speak the language! I laughed, smiled and felt light. I basked in the sunshine, greeted almost everyone I passed and just fell in love with life again. I kept thinking, "wow I wish I could stay here." 

After two weeks in Nicaragua, I traveled to Roatan, Honduras to meet a good friend from NP school. Three short hours after I arrived, I was sitting by the pool bar sipping on a cocktail when someone yelled, "We need a doctor or a nurse over here!".  I raced over to find a 6 year old boy screaming with his face covered in blood. His dad was panicking. I immediately applied pressure to the wound, cleaned him up and calmed his parents. He had a pretty deep forehead laceration which would absolutely need stitches. In the states, I would've  recommended they go to a plastic surgeon. But here we were in the middle of an island in Honduras. No plastic surgeon around. Turns out some ex-pat's knew of a little clinic a short distance away that had a Pediatric ER physician who volunteered there. After a few frantic phone calls, the doctor agreed to meet the family at the clinic. Thus, I first heard of Clinica Esperanza or Miss Peggy's Clinic as it's known on the island.

Fate had a funny way of pointing me in the path I should take. From that day on several little "coincidences" lined up making it obvious this is where I belonged. As I went through customs at the tiny airport, I passed a sign for Clinica Esperanza. I learned it was started by an American nurse in her kitchen of all places and grew into a full clinic. She shares my believe that healthcare is a basic human right and should not be denied based on ability to pay. It was this idealism that led her to open Clinica Esperanza. The poster advertised the clinic's desire to open a pediatric ward due to an intense need on the island. Funny, that's just the kind of thing I'd be good at! 

Once I got home I mulled it over and over in my head. Do I go back to life as it was or do I follow my heart and pursue the passion I've had since I was a little girl.  Dare I follow the dream that propelled me into medicine in the first place? The risk is great, but the reward immeasurable. Within a week, I resigned from my job, I secured a volunteer position at Clinica Esperanza and I started on a mad campaign to fundraise my passion. I'm using what little savings I have and selling all my belongings to finance my mission. I'm saying goodbye to friends, family and loved ones. I'm preparing to leave my favorite city and follow where my heart leads me. I've never been so uncertain of what the future holds but I've never been so certain that I made the right decision. As a good friend said to me one day when I was talking about how crazy all this sounded, "Genevieve, today is the first day of the rest of your life!". And so it begins! I'm excited to share it with you as it unfolds. 

If you feel inspired to help me serve you can donate to my mission by clicking here. Every little bit helps! Thank you for your support! I could not do any of this without you!

How it all began...

"Above all, be true to yourself, and if you cannot put your heart in it, take yourself out of it." Hardy D. Jackson

The adventure begins! I'm not sure if all of you know my story so I guess that's the best place to start. I've been working in the American healthcare system since 2003, roughly 11 years now.  I started out as an RN working in the pediatric intensive care unit at Lucile Packard Children's Hospital (basically Stanford's Children's Hospital). As you can imagine "intensive care" lived up to it's name. About a month in I experienced my first patient death. She was a young 14 year-old girl who died from complications of severe Steven Johnson's syndrome. I was horrified. I left the hospital that day jarred by the reality of just how short life is and just how lucky I was to live all to the ripe old age of 23! It seemed like such a waste that many of my days just floated by without much awareness, and here this beautiful 14 year girl didn't have such a luxury. That day I made a promise to myself. "No longer will I let life passively slip by, I will live intentionally, making my moments matter because that is the best way to honor those who are not afforded the same chance."

From Packard I became a travel nurse. I wanted more time to follow my passion of practicing medicine abroad. I wanted to bring my skills and resources to children in the developing world. This started my nomad phase. I traveled around the states working in Seattle, NYC and Miami, carrying only what fit in my car. In between contracted assignments I lived out my dream. I volunteered twice with For Hearts and Souls in Mongolia, where I rode around in an old Russian school bus delivering health care to the most rural reaches of the Gobi desert. I recovered children after heart surgery in Ulaanbaatar. I traveled to Morocco, India, Uzbekistan, Senegal, D.R. Congo, Brazil, Guatemala and Egypt with Operation Smile, helping repair facial deformities. It was in these weeks abroad I felt happiest. Despite the long hours, poor resources and frustrating infrastructure problems, I loved every minute. I felt fulfilled, it felt like medicine in it's purest form. My heart felt lighter, freer to give all the love I felt bubbling up inside. 

It was on a mission through the Gobi desert that I realized my next step. We set up a make-shift clinic in a rickety old structure in the middle of what seemed to be nowhere. The electricity was spotty at best and it decided to turn off as night fell. Families who heard word that we were providing free health care traveled for hours, some for days to reach our little shack. Some came on camels, some on horse and some by foot. Yet without electricity, we could only see patients until sunset. I was triaging, taking vitals and noting basic complaints in the front, while our doctors and nurse practitioners were doing their best to see as many patients as possible. As I looked out the door at the line of 5 or 6 distraught looking mothers, women who sacrificed so much just to be seen by a medical provider, I knew I needed to do more.  If I had more knowledge, more skills, less of these women would be standing outside. I needed to go back to school to become a nurse practitioner.

If you feel inspired to help me serve you can donate to my mission by clicking here. Every little bit helps! Thank you for your support! I could not do any of this without you!